From the Guidelines
Ulnar nerve palsy typically presents with symptoms such as weakness in grip strength, numbness or tingling along the pinky finger and half of the ring finger, and clumsiness when handling small objects, as a result of nerve entrapment which can be diagnosed using T2-weighted MR neurography 1. The symptoms of ulnar nerve palsy can be categorized into several key areas, including:
- Motor symptoms: weakness in grip strength, difficulty with fine motor movements, and muscle wasting in the hand, particularly in the hypothenar eminence and between the metacarpal bones
- Sensory symptoms: numbness or tingling along the pinky finger and half of the ring finger
- Functional symptoms: clumsiness when handling small objects, and difficulty with activities that require finger dexterity A distinctive sign of ulnar nerve palsy is the "claw hand" deformity, where the ring and little fingers remain flexed at the interphalangeal joints while extended at the metacarpophalangeal joints. The diagnosis of ulnar nerve palsy can be supported by imaging studies, such as MRI, which can show high signal intensity and nerve enlargement, and can be further evaluated with diffusion-tensor imaging and diffusion-tensor tractography 1. The symptoms of ulnar nerve palsy occur because the ulnar nerve controls most of the intrinsic hand muscles and provides sensation to the medial part of the hand. Treatment of ulnar nerve palsy depends on the cause, but may include splinting, anti-inflammatory medications, nerve gliding exercises, and in severe cases, surgical decompression or transposition of the nerve.
From the Research
Symptoms of Ulnar Nerve Palsy
The symptoms of ulnar nerve palsy can be categorized into several key areas, including:
- Loss of sensation and profound weakness, leading to a dysfunctional hand 2
- Typical clinical findings, such as:
- Loss of key pinch
- Clawing
- Loss of normal flexion sequence of the digits
- Loss of the metacarpal arch
- Abduction of the small finger 2
- Further deficits in hand/wrist function, including:
- Loss of ring- and small-finger distal interphalangeal flexion
- Decreased wrist flexion
- Loss of dorsal sensory innervation 2
- Classic stigmata, including:
- Weakness of grasp and pinch
- Poorly coordinated flexion
- Clawing of digits 3
- Sensory deficits, such as:
- Diminished sensation or dysesthesias in the fourth or fifth digits
- Pain in the proximal medial aspect of the elbow 4
- Motor symptoms, including:
- Decreased pinch strength
- Difficulty fastening shirt buttons or opening bottles 5